Moderator: Concerning the information in this video, keep in mind that laws and regulations regarding in-store
pharmacy vaccinations, including which vaccines pharmacists are permitted to administer and prescription
requirements, vary by state. Consult the appropriate resources, including the relevant state pharmacy boards, for
more information.

Welcome to another installment of Pharmacy Insider, brought to you in conjunction with the Merck Adult Vaccination
Program. I’m your host, Robin Santiago.

We are so lucky today to be joined by two highly accomplished pharmacy experts—pharmacy pioneers, in fact—who
are here to give their perspectives on year-round pharmacy vaccination.

First, let me introduce you to John Grabenstein. John is the former director of the Military Vaccine Agency, author of the
first edition of the APhA’s curriculum for Pharmacy-Based Immunization Delivery, and the current executive director of
medical affairs and policy for Merck Vaccines. John, thank you so much for being here.

John Grabenstein: Thanks Robin, it’s great to be here.

Moderator: We’re also joined by Beverly Schaefer, a longtime pharmacist from Seattle, Washington, who understands
the many issues that pharmacists face.

Beverly, thank you for being here as well.

Beverly Schaefer: Thanks for having us, Robin.

Moderator: Beverly you mentioned that almost two decades ago, your Seattle pharmacy became one of the first in the
country to offer seasonal shots.

What drew you to vaccination, years before it became a common pharmacy practice?

Beverly Schaefer: In the mid-90s, we were looking for ways to better serve our community. We were looking for a
patient-care service, and vaccination fit the bill perfectly.

Beverly Schaefer: We soon learned how much need and demand there is out there for additional patient access to
health care. And that’s what pharmacies can offer that’s so essential. I think a huge part of the future of pharmacies will
be a focus on providing improved access to patient care. And once pharmacists figure that out, there’s really no
looking back.

Moderator: John, you’re a strong advocate for improved patient access to vaccination in the pharmacy. Tell me a little
about how you arrived at this realization.

John Grabenstein: Sure. Preventive care has always been very natural to me. I like the idea of priority being given to
helping to keep people healthy. And when I realized what vaccines could do, it was very clear to me how important it was
to help prevent as much disease as possible.

Preventive care, though, is a bit contrary to human nature. We’re essentially asking everyone to plan ahead and roll up
their sleeves.

Pharmacists can help improve public health. With access to many patients, pharmacists can do their part to help prevent
serious diseases, community after community after community.

Preventive care should be natural and it should be routine.

Moderator: That’s a great point, John. Pharmacists are well-suited as vaccinators, given the amount of patients they
have access to on a daily basis.

Beverly Schaefer: That’s really true. And preventive care allows pharmacists to have an impact on a different side of
patient care than we do when we are helping people when they are sick. And—when you administer vaccines, it’s one of
the few times that you ever touch your patients, and so it takes patient care in the pharmacy to the next level.

Helping patients is a major part of what a lot of us went to pharmacy school for. There’s a lot of professional satisfaction
in that.

John Grabenstein: Oh, absolutely. I mean most pharmacists got into this line of work because they truly care about
people. The patients walking into their pharmacy—those are their people, their communities, their neighbors—they know
them, they know their children, and they care deeply about them.

Moderator: Have you noticed any specific barriers that hold back some pharmacists from incorporating vaccinations
into their year-round workflow?

Beverly Schaefer: Well, I would consider these barriers to vaccination as more perceived than real. For instance, some
pharmacists are concerned about the time it takes, especially when they are feeling overworked and understaffed.

But what I have found in my own pharmacy is that once a patient has decided to get a vaccination, administering the
vaccine takes about the same amount of time as filling a new prescription. Staff should help by focusing on the parts of
the vaccination process like the paperwork, the documentation, the insurance, and that then allows the pharmacist to
focus on the vaccination.

Moderator: Great tip, Beverly. John, what about you?

John Grabenstein: You know barriers can be overcome. We should always keep in mind the opportunities. Patients now
have increased access to vaccinations—not needing an appointment, the convenience of travelling somewhere they
are already going to pick up other items, the ability to get vaccinated in the early morning or late at night, outside of your
doctor’s office hours. It’s really a great opportunity for local pharmacies and pharmacists.

Moderator: What techniques does your pharmacy use to identify eligible patients?

Beverly Schaefer: Well, we approach it in a variety of ways, which helps ensure that we’re aware of a patient’s eligibility
for vaccination. And to help spark conversations with patients, I have signs all over my pharmacy—
I have one on my pharmacy counter; I have one near the blood pressure machine—and it asks questions like, "Are you up to date on adult
vaccinations?"

One of the most important ways pharmacists can actively identify patients, is to keep track of certain age milestones.
You can open a conversation and say, "Oh, I see you’ve reached a significant birthday."

Moderator: " Significant birthdays," I like that. John, do you have any tips to help pharmacists identify patients?

John Grabenstein: Oh, definitely. It’s about being proactive. So much of a pharmacist’s job is reactive—you respond to
a prescription that is handed to you. You fill a medication order that a physician sends you. But with vaccination, there’s a
need to switch from being reactive to becoming proactive.

For instance, there are many vaccines that are recommended for patients of certain ages who are at risk. As a
pharmacist, you have the ages of all your patients in their records. Being proactive can be as simple as alerting people
to the vaccines that are recommended for them.

We can’t assume the people who come into a pharmacy are well-informed of all vaccinations, or even that they know
they may be vulnerable to certain diseases that could be prevented. It’s adding that personal service—tapping them on
the shoulder and letting them know about the vaccinations that are available—and more importantly, letting them know
that you personally recommend them.

Moderator: So Beverly, you too have been a champion of vaccination for a very long time. As pharmacy services have
evolved, have you also noticed a change in what patients expect from you?

Beverly Schaefer: I have noticed a change. People look at pharmacists in an entirely different light now, largely as a
result of increased vaccination. And this will only continue in the future, as patients look to pharmacies even further as a
center for different kinds of patient care.

Moderator: And John, what would you say to a pharmacist who isn’t fully on board with making vaccination a
pharmacy priority?

John Grabenstein: Communities have already embraced vaccination in the pharmacy. And there are simple, low labor
ways to incorporate vaccination into your day-to-day routine. Use your computers’ screening tools. Set up alerts to
identify patients that are of the recommended ages for certain adult vaccinations.

And don’t forget to investigate what your support staff can do. For starters, they can help you communicate the
importance of vaccination by displaying signs, posters, brochures—even wearing buttons to serve as a visual cue to
prompt patients to talk to the pharmacist about vaccination.

A few conversations every day are all it takes to get started. And then, keep up the momentum. Vaccination should be a
year-round effort.

Moderator: Thank you both so much for being here. It’s truly been informative and inspiring. And pharmacists truly can
be leaders in increasing vaccination rates for adults.

I also want to thank all of you for joining us for this segment of Pharmacy Insider, brought to you in conjunction with the
Merck Adult Vaccination Program.